米粒体滑囊炎的临床、病理及影像特征  

Clinical,Pathological and Imaging Features of Bursitis with Rice Body

作　　者：李培岭 魏娟 王秀艳 郑红伟 赵振江 郭智萍 LI Peiling;WEI Juan;WANG Xiuyan;ZHENG Hongwei;ZHAO Zhenjiang;GUO Zhiping(Department of Radiology,Luoyang Orthopedic Hospital of Henan Province(Orthopedic Hospital of Henan Province),Zhengzhou 450000,China;Hennan Key Laboratory of Chronic Disease Management,Zhengzhou 450000,China;Department of Radiology,the South Hospital of the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]河南省洛阳正骨医院(河南省骨科医院)放射科,河南郑州450000 [2]河南省慢病健康管理重点实验室,河南郑州450000 [3]郑州大学第一附属医院南院区放射科,河南郑州450000

出　　处：《河南医学研究》2025年第4期594-598,共5页Henan Medical Research

基　　金：河南省科技攻关计划项目(182102310354)。

摘　　要：目的探讨米粒体滑囊炎的病因、病理、临床表现、影像学特征及治疗方案。方法回顾性分析经病理确诊的12例米粒体滑囊炎的临床、病理及影像资料,并回顾文献。结果12例中继发于类风湿关节炎5例,慢性非特异性滑囊炎4例,结核性关节炎、痛风性关节炎和CREST综合征各1例;9例单发,3例多发。MRI均表现为关节腔和(或)滑囊扩张积液,滑膜增厚,米粒体在T 1WI呈等信号,FS T 2WI及PDWI呈多发大小均匀的米粒样稍低信号,呈“瓜子样”(1/15)、“铺路石样”(4/15)和“芝麻样”(10/15)改变,部分可见“靶环征”(4/15),增强扫描滑膜增厚并明显强化,米粒体不强化;SPECT/CT融合骨显像米粒体无放射性浓聚。结论任何类型的滑囊炎均可导致米粒体的形成,米粒体滑囊炎好发于肩关节和手腕部,MRI表现具有特征性,米粒体清除和滑膜切除是治疗米粒体滑囊炎的最佳方法。Objective To investigate the etiology,pathology,clinical manifestations,imaging features and treatment of bursitis with rice body.Methods The clinical,pathological and imaging data of 12 cases of bursitis with rice body confirmed by pathology were retrospectively analyzed retrospectively,and the literature was reviewed.Results Among the 12 cases,5 cases were secondary to rheumatoid arthritis,4 cases were chronic nonspecific bursitis,1 case was tuberculous arthritis,1 case was gouty arthritis and 1 case was CREST syndrome.Nine cases were single and 3 cases were multiple.MRI showed joint cavity and/or bursae dilated and effusion,synovial thickened,these bodies presented low signal particles on T 1WI,FS T 2WI and PDWI presented multiple uniform with slightly lower signal,presenting“sunflower seed”(1/15),“paving stone”(4/15)and“sesame”(10/15)changes.Part of the“target ring sign”was seen(4/15),and the synovial membrane was thickened and significantly strengthened in enhanced scanning,while the bodies was not strengthened;SPECT/CT fusion bone imaging of rice bodies without radioactive concentration.Conclusion Any type of bursitis can lead to the formation of rice bodies,rice bodies bursitis usually occurs in the shoulder joint and wrist,MRI findings are characteristic.grain removal and synoviectomy are the best treatment for bursitis with rice bodies.

关 键 词：滑囊炎 关节 米粒体 磁共振成像 放射性核素显像 

分 类 号：R68[医药卫生—骨科学]